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Varicose veins

Vascular system and veins

Vascular system is a network of blood vessels connecting the heart with every part and organ of the body. Arteries bring oxygen- and nutrients-rich blood from the heart to the rest of the body. Veins return blood back to the heart. Blood flow through the arteries is assisted by heart acting as a pump but this flow is not as strong in the veins. Additionally blood in the veins must move upwards against gravity which puts extra pressure on the veins, especially on veins of the legs. Tiny valves on the walls of veins prevent blood from flowing in the wrong direction.

Varicose veins and other vascular disorders

When the blood does not flow normally through the veins back to the heart venous problems and disorders begin. Varicose veins are one of the mostly wide-spread vascular diseases. They occur when one-way valves malfunction, or walls of the vessels are weakened or over-stretched. The blood then can flow backward and pool in the veins of the lower legs causing venous insufficiency that over the time turns into varicose veins.

The word varicose means "twisted" and has Latin origin. Varicose veins are swollen, bulging, blue veins that are visible through the skin. They can occur anywhere, but are most often found on the back of the calf, on the inside of the leg or in the groin area.

Other types of venous disorders include:

• Spider veins – similar to varicose veins but smaller. Vary in size and often look like a spider's web or a tree branch.
• Venous lakes – pools of blood in the veins, often found on the face and neck.
• Reticular veins – flat, blue veins under the skin often appearing behind the knee.
• Telangiectases – fine clusters of blood vessels similar to spider veins, reddish in color and often found on the face or upper body.
• Chronic venous insufficiency (CVI) – reddish-brown discoloration resulting from capillary burst under blood pressure.

Causes and risks

There are a number of factors that can trigger the development of varicose veins. Generally veins weaken with age; pregnancy puts extra pressure on veins both physically and by change in hormonal balance; overweight and obesity are among top risk factors for varicose veins development. Family history of the problem, sedentary lifestyle, wearing tight outfits and spending long hours on the feet increase tendency to develop varicose and spider veins. Venous insufficiency can also be caused by inflammatory processes in the skin, high blood pressure, diseases of heart and blood vessels, gastrointestinal tract, liver, ovaries, thyroid or pancreatic gland. Varicose veins occur more commonly in women then in men.

Venous problems can be also be promoted to an extent by such external factors as extreme weather conditions; big difference between outside low and inside high temperatures; frequent contact with lime, reducers, aggressive cleaning agents and even polluted environment.

Symptoms

For many people varicose veins remain solely a cosmetic problem without any symptoms or complications. When symptoms do occur, they may include:

• aching pain or discomfort in the legs;
• leg heaviness;
• swelling of the ankles;
• itching or a feeling of burning over the veins;
• changed appearance of the skin in the affected area, some of which may worsen by the end of the day.

People with significant varicose veins may be at risk of developing more severe complications, such as:

• deep venous thrombosis (DVT);
• painful ulcers on skin near varicose veins, especially near the ankles;
• varicose eczema;
• a blood clot, referred to as superficial phlebitis (inflammation of a vein).

These conditions require immediate attention and medical treatment.

Treatment

Varicose vein treatment depends on the severity of the problem. At early stages non-surgical methods should be applied to relieve the symptoms and/or appearance.

Laser treatment

Spider and mild varicose veins and telangiectasias in most cases are just a cosmetic defect that can be effectively treated with the help of laser. The laser is a safe and effective way of treatment that works selectively on blood vessels without affecting the surrounding tissue. A target for laser impulse is the hemoglobin in the affected vessel. Under laser beam vessels become empty and their walls stick together and then dissolve without leaving traces.

Different emission filters are used depending on the nature of affection, diameter and color of damaged vessels. The procedure usually takes several minutes. If vessels are large and lay not only under the skin surface but deeper, the treatment is repeated approximately in a month.

Photocoagulation

Photocoagulation is a method of treatment that uses intense pulsed light source that heats blood vessels and coagulates blood in them. Later the vessel is overgrown with connective tissue and the skin returns to its natural color.

Sclerotherapy

Another method of treatment is sclerotherapy. A special solution called sclerosant is injected into small and medium size varicose veins, which causes vessels to swell and stick together. Over time vessels turn into scar tissue that fades out in a few weeks.

Required number of procedures varies from 1 to 5. Procedure duration is 15-45 minutes. After the procedure the doctor will suggest you walk for 10-30 minutes and walk daily for not less than an hour. Besides it is not advised to take hot bath for 2 weeks, visit spa, sauna and gym for 1,5-2 months.

Surgical removal

Vein ligation and stripping is one of surgical procedures performed on varicose veins. This procedure involves tying and removing of long problematic veins through small incisions. If a superficial vein is removed, it does not affect the circulation of blood as all blood flow goes to the deeper veins and varicose will not appear.

The surgery is done in the hospital or outpatient setting by a vascular surgeon with either general or local anesthesia. The procedure takes approximately an hour. A short hospital stay is required. A bandage and pressure stocking are applied and must be worn for a week or two. Full recovery from surgery can take several weeks.

Self-care and prevention

Prevention is always better than cure. To improve circulation and muscle tone follow these tips:

• Exercise regularly. Even walking can produce good results. Other outdoor sports like running, cycling, foot-racing and swimming are useful for invigoration of venous system.
• Maintain a healthy weight. It will reduce pressure put on legs.
• Do not cross your legs when sitting.
• Avoid standing still for long periods of time.
• Do not wear too tight clothing or undergarments restricting circulation and high heels.
• Elevate your legs 3-4 times a day for 15 minutes. When resting put legs above the level of your heart.
• Eat high-fiber foods and reduce salt intake.
• Wear compression stockings to reduce symptoms. Compression stockings can be helpful in preventing many symptoms of varicose veins. The stockings squeeze veins to prevent excess blood from leaking backward and help veins and leg muscles move blood more efficiently.

Varicose vein treatment

Varicose veins can be treated both surgically and non-surgically depending on the severity of a problem. Below is the list of varicose vein treatment procedures offered by RomiTal:

For more plastic surgery and other cosmetic procedures see: